Welcome to Medical News Today

Healthline Media, Inc. would like to process and share personal data (e.g., mobile ad id) and data about your use of our site (e.g., content interests) with our third party partners (see a current list) using cookies and similar automatic collection tools in order to a) personalize content and/or offers on our site or other sites, b) communicate with you upon request, and/or c) for additional reasons upon notice and, when applicable, with your consent.

Healthline Media, Inc. is based in and operates this site from the United States. Any data you provide will be primarily stored and processed in the United States, pursuant to the laws of the United States, which may provide lesser privacy protections than European Economic Area countries.

By clicking “accept” below, you acknowledge and grant your consent for these activities unless and until you withdraw your consent using our rights request form. Learn more in our Privacy Policy.

Please accept our privacy terms

We use cookies and similar technologies to improve your browsing experience, personalize content and offers, show targeted ads, analyze traffic, and better understand you. We may share your information with third-party partners for marketing purposes. To learn more and make choices about data use, visit our Advertising Policy and Privacy Policy. By clicking “Accept and Continue” below, (1) you consent to these activities unless and until you withdraw your consent using our rights request form, and (2) you consent to allow your data to be transferred, processed, and stored in the United States.

Increasing dopamine levels

The symptoms of PD are mainly due to low levels of dopamine in the brain. Dopamine is a chemical messenger, or neurotransmitter. Most drugs for the condition aim to either replenish dopamine levels or mimic its action. These are called dopaminergic drugs.

Dopaminergic medications can:

reduce rigidity and muscle stiffness

improve the speed of movement

help with coordination

lessen tremor

Taking dopamine itself does not help because it cannot enter the brain, but drugs that enable the brain to create dopamine can be beneficial.

Doctors may prescribe the following medications for people with PD:

Levodopa

Levodopa is the most effective medication for PD. Nerve cells in the brain absorb the drug and turn it into dopamine.

Carbidopa-levodopa

This combination drug, which is available under the brand name Sinemet, contains both carbidopa and levodopa.

Carbidopa prevents the destruction of levodopa by enzymes in the digestive tract and reduces some of its side effects, including nausea.

As Parkinson's disease progresses, long-term treatment with levodopa may become less effective.

The person's response to the drug may begin to fluctuate, and they might experience "off" times between doses, during which movement can be more challenging.

The doctor may have to change the dosage by amending the size or frequency of the doses. However, the individual will need to continue using the drug because stopping it suddenly can result in withdrawal symptoms.

Depression, psychosis, and dementia

The American Academy of Neurology (AAN) recommend amitriptyline for treating depression, stating that there is currently insufficient evidence to support the use of other treatments.

Psychosis can also occur, and this becomes more severe as the disease progresses. Clozapine (Clozaril) can treat psychosis, but doctors should monitor the person carefully as this medication can have severe adverse effects.

Dementia develops over time in many people with PD, especially if they have PD with Lewy bodies.

Lewy bodies are abnormal deposits in the brain. Rivastigmine (Exelon) is a treatment option for dementia, but the AAN point out that the benefits can be small, and it may make tremors worse. Donepezil (Aricept) is another option.

Speech and occupational therapy

Physical therapy can help people with PD to regain skills and find new ways of doing things.

Treatment for PD may also involve speech and occupational therapy.

Speech therapy: PD can cause a person to have slurred speech and abnormal body language. It can also be difficult for a person with PD to swallow.

A speech and language therapist can provide muscle-training techniques that help people overcome some of the common problems relating to speech and swallowing.

Occupational therapy: An occupational therapist can pinpoint everyday tasks that PD can make problematic, and they can help find practical solutions.

Examples include helping people with techniques for getting dressed, preparing meals, performing household chores, and doing the shopping.

Deep brain stimulation

This procedure can treat many of the symptoms that make it hard for a person with PD to function, such as tremor, rigidity, stiffness, slowed movement, and walking difficulties.

A doctor will implant an electrode inside a part of the brain that controls movement. The electrode will provide stimulation to the brain.

Next, they will place a pacemaker-like device, or neurostimulator, under the skin in the upper chest. This device will control the amount of stimulation that the electrode delivers.

A wire travels under the skin and connects the neurostimulator to the electrode.

The neurostimulator sends electrical impulses along the wire and into the brain via the electrode.

These impulses prevent symptoms by interfering with the electrical signals that cause them.

Doctors typically use deep brain stimulation during the later stages of PD, when medications become less effective.

The risks of this procedure include brain hemorrhage and infection. People who do not respond to carbidopa-levodopa therapy will not benefit from deep brain stimulation.

Thalamotomy

This is a type of surgery that was common in the past but is rare nowadays.

The surgeon uses a local anesthetic to numb the area. They then make a small hole in the skull, insert a hollow tube, and use liquid nitrogen to destroy the thalamus, a tiny part of the brain that is responsible for the tremor.

The surgeon will operate on the side of the head opposite to the affected side of the body. If a person has a tremor in their right hand, for example, the surgery will take place on the left side. It is possible to operate on both sides, but this can lead to other problems.

A thalamotomy may help if a person has a severe tremor on one side, but it does not relieve slow movement, walking difficulties, speech problems, or other symptoms.

Blood pressure treatment

Many people with PD experience fluctuations in blood pressure. Low blood pressure is common, especially when standing up or changing position.

Alternative remedies

Tai chi, relaxation, and yoga may improve overall well-being in people with Parkinson's, as well as helping them to relax.

People have tried a wide range of complementary therapies for PD, and there is anecdotal evidence that these can help with relaxation and reduce stress and depression. However, there is little scientific proof to support these claims.

the Alexander Technique, which can help with posture and muscle activity

However, more research is necessary to confirm the effectiveness of these treatments.

Supplements

Some people believe that supplements can benefit people with PD, but there is limited research to support their effectiveness.

Proponents recommend the following supplements:

Velvet bean: Also known as Mucuna pruriens, this supplement contains levodopa, but it is not clear if it has any effect as a PD treatment.

Vitamin C: There is some evidence that vitamin C can increase levodopa levels, but researchers have not yet confirmed that it can help people with PD.

Folic acid: This may help, but more research is necessary.

Vitamin E: Some people recommend vitamin E supplements, but the AAN state that they are ineffective as a treatment for PD.

Anyone who is considering using herbal remedies or supplements should speak with their doctor first, because some may interact with PD medications or make symptoms worse.

Diet and exercise

There is no evidence that any specific diet will help people with PD, but a healthful diet comprising plenty of fresh fruit and vegetables will enhance a person's overall health.

A high-fiber diet and adequate fluid consumption can help reduce constipation, which is a common problem with PD.

Weight loss can often occur too. A dietitian should be able to offer advice on how to prevent this.

Exercise

Physical therapy can help people manage their symptoms and feel better. A 2013 review in Reviews in the Neurosciences reported that exercise improves gait, mobility, and balance in people with PD.

Exactly how exercise can help a person with PD is unclear, but animal studies have suggested that it may offer some neuroprotection.

Moderate activities, such as walking, gardening, and swimming, are suitable for many people. They can often improve emotional well-being too, especially if the individual can do them with a friend, family member, or another person in the community.

It is essential that people with PD speak to their doctor before making any changes to their level of exercise.

Takeaway

Parkinson's disease affects individuals in different ways, and a doctor will prescribe or recommend appropriate therapies to relieve the symptoms.

These include a range of medications, lifestyle changes, and other interventions.

It can take time to get the treatment right, and symptoms can also change over time. Staying in touch with the doctor is important for maintaining a suitable treatment regime.

This, in turn can improve the quality of life of a person with PD and their loved ones.

2019 Healthline Media UK Ltd. All rights reserved. MNT is the registered trade mark of Healthline Media. Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional.